nothing, and on the second visit to the emergency room he told the attending doctor, "I think she may be hurting the bab " A physician is required by law to report credible suspicions of abuse, and the doctor called child-protective services. The two incidents involving reflux, and a visit Heather made to a urologist to consult about adhesions she had noticed on the baby's foreskin, were the only medical inquiries she had made that were not routine. Nonetheless, Heather fit the profile: she was a nurse; she had a good store of medical knowledge, which she was not shy about sharing; she was a wor- rier; and she was crazy about her bab As a result of the investigation, the child was placed with Heather's in-laws, with whom she did not get along. She was allowed to see her baby for two su- pervised visits each week. During these visits, Heather was not allowed to give any food or liquid to the baby-if she re- ally was a Munchausen mom, she might try to poison him. The state's investigation dragged on for six months, as a family-court judge held hearings on the dispute. The gas- troenterologist who treated the baby did not think Heather suffered :&om M.S.B.E He thought that she might have over- reacted, but that such overreactions were common among new parents. (Heather herself acknowledged as much-the di- vorce had been stressful.) The urologist, ,too, agreed that Heather's inquiry was appropriate, and confirmed that the baby had redundant foreskin. In January, the judge dismissed the allegation against Heather, and her son was returned to her. Heather's stepfather, Tom, who, along with her mother, had accompa- nied her to court and helped pay for her defense, sent an e-mail to family and friends: "Lawyer's fees-$25,000 plus. Dr. Mart-$7,000. Dr. Annie-$5,000. Sitting on the couch with a smiling, laughing baby boy-priceless." When I visited Heather on a wet, gray afternoon recently, she was pad- ding around in a cardigan and socks. She served Tom and me a lunch of homemade lasagna and cooed at her son, who sat in his high chair, pink-cheeked and wriggly. "Hi, handsome!" she said brightly, kissing him on his head and of- fering him a teething biscuit. She said that she felt lucky to have her baby back, yet she was furious to 70 THE NEW YORKER , AUGUST 9 & 16 , 2004- have "lost six months of his life." The false accusation, she said, made her feel "like I was being swept out into a riptide. In the beginning, I just kept thinking, These are professionals; they'll figure it out. I'll have him back in a few days. And then it went on and on." M ore recently, some experts have begun stretching the M.S.B.E di- agnosis even further. They are applying it to mothers who spend too much time visiting schools, not hospitals-to moms who "overadvocate" for special-education services, or aggressively seek diagnoses of cognitive or psychological difficulties, such as attention deficit disorder or dys- lexia, for their children. Herbert Schreier, the influential co- author of "Hurting for Love," has written that school psychologists and behaviorists have become the "new targets" for ma- nipulative mothers. He describes them, chillingl)T, in a 2000 article in the Journal of the American Academy of Child andAdo- lescent Psychiatry, as powerful figures with "the uncanny abilities of the psychopath or imposter to simulate someone above suspicion. " To complicate matters, some of these bad mothers are themselves psy- chologists or learning specialists, Schreier maintains, and thus have "broad and de- tailed knowledge of the mental-health field" with which to dupe school officials. Schreier has argued that "we need to change the definition" of M.S.B.E "by expanding the target audience of the mother" still further "to include police investigators, child-protection workers, lawyers, and school personnel"-any- one, it seems, in authority: The philoso- phers David B. Allison and Mark S. Roberts note, in their book "Disordered Mother or Disordered Diagnosis ," that the definition of a Munchausen mom has devolved into "a manipulative person who seeks attention from somebody who can be construed to hold power of some kind: that is, probabl)T, anybod " Randell Alexander, the M.S.B.P. scholar at the University of Florida, told me, "I think most of us would prefer to be more conservative. We'd probably like to save the M.S.B.E label for something where the child is going to be poked with a needle by a doctor." But it's prob- ably too late for such circumspection. A 2002 special issue of the journal Child Maltreatment carries an article entitled "Munchausen by Proxy: Presentations in Special Education." It ends by listing some "common presentations" of moth- ers who have this problem-a new pro- file that's strikingly like the old one, but with "educational" substituted for "med- ical." Thus diagnosticians are warned to be on the lookout for "a parent (usually the mother) who appears to be educa- tionally knowledgeable and/or fascinated with details of educational or learning disabilities, appears to enjoy the school environment, and often expresses inter- est in the details of other children with educational problems." Family courts considering M.S.B.E cases are likely to hear estimates of mor- tality rates presented by the prosecution. These will probably be based on cases of medical abuse in hospital settings. Yet the new cases are often presented as though they shared a similarly dismal prognosis. The Child Maltreatment arti- cle quotes death rates of between nine and twenty-two per cent in Munchausen families. Even for hospital-abuse cases, twenty-two per cent is probably too high; Marc Feldman and others say nine per cent is more realistic. And, in any case, it seems a stretch to suggest that a mother who tries to get a child a diagnosis of at- tention deficit disorder (even if she's doing a nonnal child a disservice) is as dangerous to her children as a mother who systematically smothers her baby. Yet some M.S.B.E experts argue that the one behavior lies on a continuum with the other. In a variation on the old slippery- slope argument, angling for a learning- disorder label (and perhaps a better class placement) is seen as the equivalent of smoking marijuana, and smothering a child is tantamount to smoking heroin: one, it is feared, could lead to the other. A judge who worries that a child could end up dead may well err on the side of cau- tion, and place him in foster care-a drastic step that can cause children to suffer tremendousl Eric Mart recently testified in a case involving an M.S.B.E accusation from school officials. The mother, who lives in Massachusetts and has a son and a daughter, "came to school and said her kids had terrible learning disabilities and kept demanding more evaluations and out-of-district placements. When offi- cials took a good look, they were con- cerned whether there was anything